Hi, I am just trying to get my head around all of my heart related things.

I was diagnosed with inappropriate sinus tachycardia about 10 years ago:

- After blacking out and feeling really unwell I saw a doctor and had an ECG done which showed an abnormal p-wave, I was referred to a cardiologist.

- treadmill test showed the following, from heart rate at rest of 81 went to 130 within 15 seconds of exercise, then to 173 within 3 mins of exercise, then after 3 mins 15 seconds it was 182, at that stage I was dizzy and the test had to be stopped.

- I was given Visken beta blocker 10 mg a day

- A month later treadmill test was repeated and heart didn't go over 100

- Visken was reduced to 5 mg a day then finally was told to stop taking it.

- A year later of continued presyncope and blacking out I had a positive tilt-table test - showed 3 prolonged pausesbetween 5-7 seconds each after 34 mins
this was diagnosed as neurocardiogenic syncope.
the test showed bradycardia and hypotension.

- ECG showed short PR interval 0.12 seconds

- Was prepped for EP study, but then they cancelled it at the last minute.

- given Disopyramide 250 bd

- tilt test repeated a month later was normal, but I still had presyncope feeling: nausea, light headed hot

- continued to have pre-syncopal episodes and palpitations.

- changed to Atenolol 50 mg per day

- increased to 100 mg per day

- changed to imipramine

- was told I would be vulnerable to "vaso depressor syncope" for the rest of my life and that the symptoms could be containable if I controlled my life stresses!!!

- While in CCU they found that when I tried to sleep my heart rate would go below 32 or slower.

- finally after 4 years I was given a pacemaker which is dual chamber on-demand, it controls my heart when it goes too slow, but does not do anything for fast rate. This was done 6 years ago. Things improved very much after that, I was less tired, no passing out, hardly any dizzy spells.

- Last year the fast heart started to get bad again, palpitations, breathless walking up hill, climbing stairs a killer, my GP just said to do Valsalva manoevre to slow heart down again but it didn't help.

- I was also getting bad chest pains, was admitted to hospital many times, ECGs were normal.

- Had normal angiogram, was told possibly variant angina but unlikely, they thought it was esophageal spasm.

- Nitrolingual spray helped get rid of pain

- this year still having chest pain and exhaustion exertion.

- Saw cardiologist yesterday, had echocardiogram which shows I have a small heart, he told me that this means my heart is having to work hard, he also said that it also makes my heart very sensitive to adrenaline and also medications that will affect heart. He also said that I must never use anticholinergics.

- he thinks that my dizziness is the inappropriate sinus tachycardia again

- started on Cardizem 180 mg CD, he said it will help the chest pain syndrome and also slow my heart down.

please please let this be the answer, it will be wonderful for me to be able to do my gardening without feeling like I am going to pass out after a marathon.